Effects of telmisartan on vascular endothelial function, inflammation and insulin resistance in patients with coronary heart disease and diabetes mellitus

Chen,Tao; Xing,Jieyong; Liu,Yanshao

doi:10.3892/etm.2017.5451

Effects of telmisartan on vascular endothelial function, inflammation and insulin resistance in patients with coronary heart disease and diabetes mellitus

Authors:
- Tao Chen
- Jieyong Xing
- Yanshao Liu
View Affiliations

Affiliations: Department of Cardiovascular Medicine, Zhangqiu Hospital of Traditional Chinese Medicine, Jinan, Shandong 250200, P.R. China
Published online on: November 6, 2017 https://doi.org/10.3892/etm.2017.5451
Pages: 909-913
Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of the present study was to investigate the effects of telmisartan on vascular endothelial functions, inflammatory factors and insulin resistance of coronary heart disease patients complicated with diabetes mellitus. In total, 80 coronary heart disease patients complicated with type 2 diabetes mellitus, admitted and treated in the Zhangqiu Hospital from January 2016 to March 2017 were enrolled in the study. Each patient was randomly assigned to an observation (n=40) or a control group (n=40) using a random number table. Conventional symptomatic and supporting therapies were administered to all the patients in the two groups for 12 consecutive weeks, while additional telmisartan was given only to patients in the observation group. Markers of glucose metabolism, vascular endothelial function and inflammation were determined before and after intervention, to compare averages between groups. Results showed the levels of fasting blood glucose and blood glucose in the observation group were significantly lower than those in the control group (p<0.05) after 4 weeks of treatment. The levels of HOMA-IR in the observation group were clearly improved compared to those in the control group during the same period (p<0.05). After the intervention, the levels of FINS and HOMA-IR in the observation group improved significantly more compared with those in the control group (p<0.05), while the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) were much lower than those in the control group (p<0.05). Furthermore, at the 4th, 8th and 12th week after starting the treatment, the vascular endothelin (ET) levels in the observation group were significantly lower than those in the control group (p<0.05). In addition, the brachial artery diameters in the basal state were significantly larger than those in the control group (p<0.05) for the same time-points. Coronary heart disease patients complicated with diabetes mellitus whose treatment includes telmisartan can better regulate their blood glucose, reduce the insulin resistance and body inflammatory responses and improve their vascular endothelial functions.

View Figures

View References

1	Park S, Kario K, Park CG, Huang QF, Cheng HM, Hoshide S, Wang JG and Chen CH; Characteristics On the ManagEment of Hypertension in Asia-Morning Hypertension Discussion Group (COME Asia MHDG), : Target blood pressure in patients with diabetes: Asian perspective. Yonsei Med J. 57:1307–1311. 2016. View Article : Google Scholar : PubMed/NCBI
2	Bays H, Gao P, Völker B, Mattheus M, Ruilope LM and Zhu D: Efficacy of single-pill combination of telmisartan 80 mg and hydrochlorothiazide 25 mg in patients with cardiovascular disease risk factors: A prospective subgroup analysis of a randomized, double-blind, and controlled trial. Int J Hypertens. 2013:7498302013. View Article : Google Scholar : PubMed/NCBI
3	Verdecchia P, Dagenais G, Healey J, Gao P, Dans AL, Chazova I, Binbrek AS, Iacobellis G, Ferreira R, Holwerda N, et al Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint TrialTelmisartan Randomized AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease Investigators, : Blood pressure and other determinants of new-onset atrial fibrillation in patients at high cardiovascular risk in the Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial/Telmisartan Randomized Assessment Study in ACE intolerant subjects with cardiovascular Disease studies. J Hypertens. 30:1004–1014. 2012. View Article : Google Scholar : PubMed/NCBI
4	Takagi H and Umemoto T: Telmisartan increases adiponectin levels: A meta-analysis and meta-regression of randomized head-to-head trials. Int J Cardiol. 155:448–451. 2012. View Article : Google Scholar : PubMed/NCBI
5	Nilsson PM: Target blood pressure in diabetes patients with hypertension - what is the accumulated evidence in 2011? J Zhejiang Univ Sci B. 12:611–623. 2011. View Article : Google Scholar : PubMed/NCBI
6	Hong SJ, Choi SC, Ahn CM, Park JH, Kim JS and Lim DS: Telmisartan reduces neointima volume and pulse wave velocity 8 months after zotarolimus-eluting stent implantation in hypertensive type 2 diabetic patients. Heart. 97:1425–1432. 2011. View Article : Google Scholar : PubMed/NCBI
7	Toyama K, Nakamura T, Kataoka K, Yasuda O, Fukuda M, Tokutomi Y, Dong YF, Ogawa H and Kim-Mitsuyama S: Telmisartan protects against diabetic vascular complications in a mouse model of obesity and type 2 diabetes, partially through peroxisome proliferator activated receptor-γ-dependent activity. Biochem Biophys Res Commun. 410:508–513. 2011. View Article : Google Scholar : PubMed/NCBI
8	Cowan BR, Young AA, Anderson C, Doughty RN, Krittayaphong R, Lonn E, Marwick TH, Reid CM, Sanderson JE, Schmieder RE, et al ONTARGET Investigators, : Left ventricular mass and volume with telmisartan, ramipril, or combination in patients with previous atherosclerotic events or with diabetes mellitus (from the ONgoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial [ONTARGET]). Am J Cardiol. 104:1484–1489. 2009. View Article : Google Scholar : PubMed/NCBI
9	Chang WT, Cheng JT and Chen ZC: Telmisartan improves cardiac fibrosis in diabetes through peroxisome proliferator activated receptor δ (PPARδ): From bedside to bench. Cardiovasc Diabetol. 15:1132016. View Article : Google Scholar : PubMed/NCBI
10	Toma I, Kim PJ, Dash R, McConnell MV, Nishimura D, Harnish P and Yang PC: Telmisartan in the diabetic murine model of acute myocardial infarction: Dual contrast manganese-enhanced and delayed enhancement MRI evaluation of the peri-infarct region. Cardiovasc Diabetol. 15:24–25. 2016. View Article : Google Scholar : PubMed/NCBI
11	Chen AX, Jerums G, Baqar S, Lambert E, Somarajah G, Thomas G, O'Callaghan C, MacIsaac RJ and Ekinci EI: Short-term dietary salt supplementation blunts telmisartan induced increases in plasma renin activity in hypertensive patients with type 2 diabetes mellitus. Clin Sci (Lond). 129:415–422. 2015. View Article : Google Scholar : PubMed/NCBI
12	Chaudagar KK and Mehta AA: Effect of telmisartan on VEGF-induced and VEGF-independent angiogenic responsiveness of coronary endothelial cells in normal and streptozotocin (STZ)-induced diabetic rats. Clin Exp Hypertens. 36:557–566. 2014. View Article : Google Scholar : PubMed/NCBI
13	Rizos CV, Liberopoulos EN, Tellis K, DiNicolantonio JJ, Tselepis AD and Elisaf MS: Combining rosuvastatin with angiotensin-receptor blockers of different PPARγ-activating capacity: Effects on high-density lipoprotein subfractions and associated enzymes. Angiology. 66:36–42. 2015. View Article : Google Scholar : PubMed/NCBI
14	Antoniou T, Camacho X, Yao Z, Gomes T, Juurlink DN and Mamdani MM: Comparative effectiveness of angiotensin-receptor blockers for preventing macrovascular disease in patients with diabetes: A population-based cohort study. CMAJ. 185:1035–1041. 2013. View Article : Google Scholar : PubMed/NCBI
15	Michel MC, Foster C, Brunner HR and Liu L: A systematic comparison of the properties of clinically used angiotensin II type 1 receptor antagonists. Pharmacol Rev. 65:809–848. 2013. View Article : Google Scholar : PubMed/NCBI
16	Dehghan M, Mente A, Teo KK, Gao P, Sleight P, Dagenais G, Avezum A, Probstfield JL, Dans T and Yusuf S; Ongoing Telmisartan Alone and in Combination With Ramipril Global End Point Trial (ONTARGET)/Telmisartan Randomized Assessment Study in ACEI Intolerant Subjects With Cardiovascular Disease (TRANSCEND) Trial Investigators, : Relationship between healthy diet and risk of cardiovascular disease among patients on drug therapies for secondary prevention: A prospective cohort study of 31546 high-risk individuals from 40 countries. Circulation. 126:2705–2712. 2012. View Article : Google Scholar : PubMed/NCBI
17	Volpe M: Preventing cardiovascular events with angiotensin II receptor blockers: A closer look at telmisartan and valsartan. Expert Rev Cardiovasc Ther. 10:1061–1072. 2012. View Article : Google Scholar : PubMed/NCBI
18	Guo Z, Zhang R, Li J and Xu G: Effect of telmisartan on the expression of adiponectin receptors and nicotinamide adenine dinucleotide phosphate oxidase in the heart and aorta in type 2 diabetic rats. Cardiovasc Diabetol. 11:94–111. 2012. View Article : Google Scholar : PubMed/NCBI
19	Kappert K, Böhm M, Schmieder R, Schumacher H, Teo K, Yusuf S, Sleight P and Unger T; ONTARGET/TRANSCEND Investigators, : Impact of sex on cardiovascular outcome in patients at high cardiovascular risk: Analysis of the Telmisartan Randomized Assessment Study in ACE-Intolerant Subjects With Cardiovascular Disease (TRANSCEND) and the Ongoing Telmisartan Alone and in Combination With Ramipril Global End Point Trial (ONTARGET). Circulation. 126:934–941. 2012. View Article : Google Scholar : PubMed/NCBI